The Non-Compliant Patient

I don't write too much about my nursing life. It's too personal...sometimes. I have these feelings about nursing....lots of them...it's my job. I do what I think is the right thing to do and it treats me well....food on the table, a roof over my head. It is what it is.
Last night my patient said "I bet you've seen a lot." Yup, good and bad, miracles and not-so-good. Some of what I see are non-compliant patients...those who fly straight into the face of the medical community and against medical advice (and sometimes common sense) to do what they want. It is frustrating to care for someone who doesn't want much done but doesn't want to leave the hospital, doesn't want to change their code status (they usually are full code but don't want anything done...sort of like hitting your hand with a hammer and not letting anyone take the hammer away), and doesn't want to....the list goes on and on.
We had a patient recently who not just fit the picture but posed for it, too. "NO, I don't want a PICC. NO, I don't want a foley." He was gruff and messy...and had crude language, too. Just the thing to make the hairs on the back of your neck to stand up.
I stopped in one day just to say hello. I told him I wasn't his nurse, wasn't there to stick him or do anything, just there to say hi and see how he was doing. He looked at me like I was crazy then relaxed and started talking. He told me how sick he was, how he was "easing on out." I asked why he changed his code status back to full code...full court press we sometimes call it....and he shrugged. It was then I realized this rough and tough guy was scared of dying. He told me he'd been all over, saw a lot and did a lot. "You know what you would like?" he asked. "Fishing in Montana. Watching the sun come up there and eating fresh fish." For that brief moment he left the hospital..I could see it on his face..then he asked why he felt so bad. I told him what I thought was happening and suggested he got back to bed to rest...which he did.
Not so mean, not so big and bad, not so gruff...just sick and scared. He had lived life on his terms and now it was coming to an end....out of his control.
I stopped in to see him before he transferred out of the unit. He took my hand and told me I was a good friend. I almost cried....almost.
I wonder how often we are non-compliant patients. I know I've been one. I'm good while I am sick but then there's other times.....My doctors would shake their heads when I'd tell them the things I did in spite of being told not to.
Today I'll be a good patient, take my pills, exercise, not eat too much. Not sure about tomorrow, though.
Post by Eileen Patterson